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Home My WebLink AboutMCMAHON BLK 2 LT 6 Municipality of Anchorage Page J of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~'C~J q~' ~3o ~ PID Number: Ol-/ '- O~J -7.3 Name: ~FF ~ ~'~ ~ Wastewater System: ~ New ~ Upgrade Address: ~1~ ~0~ ~ff, ~E~ O~ ABSORPTION FIELD Phone: ~: No. of BeSeems: ~Deep Trench Q Shallow Trench D Bed D Mound D Other Total Depth from original grade: LEGALDESCRIPTION Sol, ~.~: 0.~ GPO/Sq. Ft. ~.Ce Subdiv~ion: Depth to pipe boffom from original grade: Gravel depth ~e~ pipe ~ot: ~ ~ock:~ ~H~o~ I.C~-- ~.~l ,t. Township: Range:-- ~ Section:~ . Fill added a~ove original grade:j ' _ ~. ~ I Ft. Gravel length:~, ~ ~ ~l ~C~ Ft. Gravel width: t Number of lines: Distance baleen lines: WELL: E~s~,~ New D Upgrade~ Z Ft. ~ J~ ~ Ft. Classification (Private, A,B,C): Total ~ ~sed To: Total absorption area~ Pipe material: Y~ GPM~PumpSetat: Ft. Cas]ngHeightAboveGrou~: TANK SEPARATION DISTANCES ~ Septic ~ Holding ~ S,T.E,P. To Septic Absorption LiE Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer U.., ~G~ ~ I Number of Compa~ments: Waif 1Del+ jZ~I~ -- ~ ~1~ Material:~L Surface Water /~l~ }001f ~ -- -- LIFT STATION Line - "Pump on' level at: ~alarm at: Foundation ~ ~ ~l + ~ __~ Cudain pu~ ~~ti~s p~o~ed ~ Drain ~_ ~0N~ Remarks: Ioo~ ~ ~o~u~ ¢~ ~ BENCH MARK Location and Description: Assumed Elevation: Inspections pe~ormed by: ~.~.~,C. ,, ~. Dates: 1st Department of Health and Human Se~ices approval -~,.....~..~ · .. Reviewed and approved by: ~~ ~ ~ Date: ~'~' ~ "= :~ "~"~'" "~ 72-013 (Rev. 9/91) MOA 25 DRAWING PA.CE.,O NUMBE.; PERMIT NU'MBER: AS BUILT017-041-28 sw9go013 ' ".. McMAHON AVENUE ~ A B I '"40, ~ ' ¢ 12¢0 d/~LON DBL1 CO 49.0 27.2 --I % 68 3 26 5 MT1 i HOUSE i ABANDONED ~ SUCH T~T 10' ~1~ ~SMENT ~L&S~& WA~~ WA~t~wA't'~ CONS~TA~S, ~C. PHONE; (907) 337-6179/F~; (907) 3~-5246 McMAHON SUBDIVISION; LOT 6, BLOCK 2, AS-BUILT OF SEPTIC SYSTEM UPGRADE PREPPED FOR: PHONE NUMBER: J.L.M. 1 = 40' 2 OF 2 A 'B FCO 25.4 - ST1 28.5 19.7 ST2 34-.1 20.9 DBL1 3.5.5 21.4 BBL2 36.1 21.7 CO 49.0 27.2 601 49.1 25.4. 602 55.3 10.1 C03 68.3 41.6 ~04 68.3 26.5 MT1 52.9 14.7 MT2 68.1 53.8 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 PO. Box ~96650, Anchorage, AK 995~9-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Feb 12, 1999 Expiration Date: Feb 12, 2000 Permit Number: SW990013 Legal Description: MCMAHON BLK 2 LT 6 Design Engineer: 0041 AK Water & Wastewater Consulta Owner Name: JEFF & PAIGE SPATZ Owner Address: 3830 MCMAHON AVE ANCHORAGE , AK 99516-2822 Parcel ID: 017-041-28 Site Address: 003830 MCMAHON AVE Lot Size: 32170 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] SepticTank [] Holding Tank [] Privy [] Private Well ~ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AACS0 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B N Anchorage - Alaska 99504 (907) 33%6179 ~ Fax (907) 338-$246 Consulting Engineers February 8, 1999 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic System Upgrade Design for Lot 6, Block 2, McMahon Subdivision To whom it may concern: The existing 4 bedroom house is served by a private well and septic system. On January 22, 1999, a site visit by our company was performed and determined that the drainfield is in a state of failure. The septic system must be upgrade prior to the sale of the house. Comments regarding the proposeddesign are summarized as follows: 1. SOILS: A test hole was excavated and a percolation test was performed in the test hole. The soils below the organics is a SM material to a SP/SM material to a depth of t 6 feet (bottom of test hole). ~ percolation test was performed between the depth of 7.0 feet to 7.5 feet and found the percolation rate to be <1 minutes/inch. No groundwater was encountered at the time of excavation. It is our opinion by a visual rating of the soils that a 0.8 gallons/day/fi2 should be used. 2. TRENCH (PRESSURIZED) DESIGN: a. Percolation Rates: <1 minutes/inch b. Allowable Application Rate: 0.8 gallons/day/ft2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 750 ft2 f. Maximum Total Depth: 10 feet (maximum) g. Effective Depth: 7 feet (clean, washed sewer drainrock) h. Width: 2.5 feet i. Reduction Factor = N/A j. Minimum Length: 54feet k. Effective absorption area = 756 ft2 (750 fl2 OK) 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: As can be seen on the attached design drawing, there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. ~Sincerely~/ NOTE: Attached is a site plan drawing, a design drawing, a soils log and a 4 page cora'truction specification letter which are alt part of the design package for the upgrade of this septic system. LOT lB. BLOCK 1. L MCMAHON S/D LOT 15, BLOCK 1, MCMAHON S/D ,~ "~ ~ ~ "~"- ~ LOT 17. BLOCK 1, LOT 14, BLOCK 1, ~ / ~ ~ MCMAHON / / ~ It ~. [J , lOP' WELL ~,US ~t (~PROX, LOg,) / ~ / MCMAHON AVENUE ~ I ~ ~ /~ ~ 1/ 4 BEDROOM ~ ~ HOUSE . ~ I ~~ X. LO~ 7, ~LOCX ~, -~ / LOT 4, BLOCK 2, ~ ~: MCMAHON S/D ~ ~ ~ ~ ~ ~ MCMAHON S/D PROPOSED SEP~C OPCODE~ :l (SEE DESIGN, PAGE 2 OF 2) ...................... ~o'~ ~, ~oc~ ~, MC~AHON S/O LOT 16. BLOCK 2, MCM~ON S/D LOT 15, BLOCK 2. MCMAHON S/D LOT lB, BLOCK 2, / =~ ~,~// _ul,~ % /~ ~ LOT 14, BLOCK 2, ~u~ow cR~g~ ~OA~ ~ ~ t, ~ ..... 6901 DE~R R~ SU~ 28, ~CHO~GE, AK 9950~ PHONE (907)~37 6179/F~ (907)~3" 324~ ~'~ : - : - ~ -' ,,, LEOAL DESCRIP~ON: ~ su.o,v,s,o : LOT .LOOK ..... SITE P~N FOR SEPTIC UPGRADE JEFF · PAIGE SPATZ SCOTbND: 011-44-1224-740-119 2/5/99 ~.L.M. ~ -- ~uu ] · '\ ' ! '~\ / ~\ / \ / / ~ ~ / N~/ / N ' MCMAHON AVENUE / ~ / I ~ t I ~'~d~1 ~/ ~l // I I / IIl j/ ~WELL I I I I I ~~.~ 1~ . , // ' ~ I I ~ I I / ~ / ~ I ~ / EXISTING / ~ I .5 4 BEDROOM / ~,Ne ~E~I6 TANK i HOUSE // /TO BE COMPL~ELY A~NDONED I h~ PROPOSED 1250 G~LON / ~ j 8~ INSTA~ DBL CO ~ ~ ~°1 ..... I ~NC~ j ~j Co~UT ~-CO ~TH~I %~ / / (APPROX. . J ~ ~ '~ / / LOOA~ON) I I ~ . IJ lJ O ' ~ ~l~g TRENCH IS TO BE J J ~ANDONEO I ] ~PROPOSEO ~ENCH ~CAVATE MT/SUM I ] ~ I0 FE~ BEEP (M~IMUM) BY ~Y BE USED IN ~E FUTURE, ~ ~ ~ 2.5 ~ WIDE ~ 54 FE~ ~ ~ [ LONG, ADD 7 ~ OF % A W~HED S~ER D~INROOK. I I NOTES: J j I 1. THE CO~CTOR S~L HAVE THE 100' WELL ~DIUS I j I ~66ED BY A REGISTERED ~NB SU~OR PRIOR TO ~ CONSTRUC~ON, I 2. THE CO~CTOR S~LL RE~ ~R ~ THAT A~ i ~ SEP~ON DISTANCES WILL BE M~ PRIOR TO j I CONSTRUO~ON.. McMAHON SUBDIVSION; LOT 6; BLOCK 2; ~ ................... -44-1224-740-119 g53 ....'. SCOT~ND: 011 JEFF · SPATZ J.L.M. 1 = 40' 2 OF 2 AI,&SK& WATER Si:: WASTEWATER CONSULTANTS, INC. ~ 0...F, PHONE (907) 337-§17g ,e FAX (907) 338-3246 IS01L LOG - PERCOLATION TESTI DEPTH ..... TEST HOLE #1 ~;°-~ ~ ........... ox-,=,¢-<'~'~ (f..t) ORGANICS ~', !IfI{ SOIL CLASSIFICATIONS \ 2-- c .',~. ', / MCMAHON AVENUE /' I ~CL ,-- I, l~ I I t~ SM SC ~E~] N '-~--EXISll NO '!!{! DEPT. To DATE i,I~I! PRIMARILY SM 1/27~99 ' ' "' 8-- ~ e~"~ Dl~f 10-- ~$~$ CLOCK NET TIME WATER LEVEL NET DROP 11-- ~,~ DATE READING ~ ~,.~ TIME (MINUTES) RE,lNG (INCHES) 12-- ~-.~.,~f~T~ 1/27/99 - NO PHI SO~ REQUl ~ED. ~ ' ' ' 6" ~ 'e'~" 6" 14-- ~ "~[" 4 5 MIN. 0" 6" 15--[ ~ 5 6 _ 3:05 MIN. 0" 6" 16--- B.O,H. 17-- 18-- 19-- PERCO~TION ~TE <1 (NIN./INCH) PERC. HO~ DIA. 6" (INCHES) 20 TEST RUN BE~EEN 7.0 CONNENTS: INSUTI SOILS SHOULD ACT AS A SAND FIL~ /]' ~ ' / THIS WAS PERFOR~ED/N ACCORDANCE WITH ALL S~( ~ ~CIPA~ELINES IN EFFECT ON THIS DATE. DATE: DEPTH TO DATE ROUNDWATER ~DRY 1/27L99 :~'~" MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME MAI LING ADDRESS 2~R ~X i~Tq F LEGAL DESCRIPTION LC)CATION ~ '::~ ~ ~T A~.)N CETO: IWell ~ C~ ~ L~ Absorption area g ~ j Manufacturer ~ ILiq. capacity in gallons IF HOME.DE: ~ ,. ~ DISTANCE TO: I® ~ I Manufacturer I IDISTANCE TO: IWe'' iO0"~ ~ ~ ~ I NO. of lines ] I Length of each lin~ ~ Top of tile to fin~h gr2de ~ ~ w~d~ ~ ~ I Type of crib ~ lCl~ Depth ~ [ ~ Bu,ld,ng foundat,o~ Z, L~ Lo Inside length Dwe ng Foundation Depth Crib depth Driller Sewer line Dwelling Material W dth Total length of lin~.~ Material beneath tile PHONE [] NEW :~//d'-.¥&,l(o ~UPGRADE NO. OF BEDRO~cMS PERMIT NO. No. of compartments Liquid depth PERMIT NQ. Material Liquid capacity in gallons Nearest lot line Trench widt~/ -~.O i nc h es /~-9(~'') inches PERMIT N O, ~ ~.~/O Distance between lines Total effective absorption area 7~0 PERMIT NO. Total effective absorption area Building foundation Nearest lot line Distance to lot line PERMIT NO. Septic tank Absorption area(s) OTHER PIPE MATERIALS INSTALLER APPROVED 72-013 (Rev. 3/78) DATE LEGAL F'ERMIT NO. ,' :=-',~:06:LL=~ ) AF'F'L I CANT LOCAT I ON L. EGRL ALLAN AE:,RIAN I',-i C H Fi FI G N LGB2 MCMAHr]N S[:, LOT SIZE 4F~0R SQUARE FEET TYF'E OF SOIL RE:SORF'TI¢IN SYSTE['I tS: TF.:ENE:H MA',:.::IMLIi"I NLIi'IBEF.: OF E:E[:,F.:Fu_3MS = 4 SOIL RATING ,'S-.] FT,-.'BF.:)= THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: THE LENGTH DIMENSION IS THE LENGTH (!N FEET) OF THE TRENCH OR C, RRiNFIEL. D. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE tS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE E',:.:',CR',/BTION (IN FEET). E:EE~L.I Z ~:E[:. SEP1- Z C: TRf-~::: S Z ZE= t25C~ PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY HELLS R[:,JRCENT TO THIS F'ROPERT9 AND THE NUMBER OF RESIDENCES THAT THE WELL WiLL SERVE. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AN[:, RPF'ROVAL BY THIS [:,EPAF.:TMENT WILL E:E SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETWEEN A WELL AND ANY ON-SITE SEWRGE DISPOSAL SYSTEM IS ±00 FEET FOR A PRIVATE WELL OR .158 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. IdlNIMUM DtSTRNCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS IdAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIRGRRIdS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F"EF:~'-t ][ T E"-:-=:F" I F-:ES [:.E£:EI'-IE:EF: _---::1.- -" "-- '-- .... I CERTIFY THFIT · 1: ! RM FAMtLIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE NUNICIPALiTY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. Z-':: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF TNE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. APF'L i CANT ALLFIN ADRIAN MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONIV]ENTAL PROTECTION 82§ L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG-- PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: ALi- A ~/ A ~l~ 1 /~x 1"~' LEGAL DESCRIPTION: 1 3 ..,.,~ 4 - 5- 6 7 9 10 11 12 13 .WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? 14 17 18 19 20 COMMENTS DATE PERFORMED: SLOPE SITE PLAN 0 P E Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~,~ TEST RUN BETWEEN PERFORMED 72-008 (6/79) ] .~ (minutes/inch) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAl PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage. Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE ~ 'E~'hEW ~IAME Robel't Fore~B.~ 243-1~0/0 ~ UPGRADE MAILING ADDRESS 67il Litlden Dr. LEGAL DESCRIPTION ~, B2, hchahon Sub. hOCATION NO. OF BEDROOMS DISTANCE TO: { Well 10~b F HOMEMADE: ~*~UDiSTANCE TO: Well ~ Manufacturer I ~Z I DISTANCE TO: I - ~ No. of lines 4 ILength of each line Top of tile to finish grade o ~- Length Width I Type of crib Crib diameter ~Cl~s Depth [ ~ Bu,ldmgfoundat,o~ Absorption arb~a -'~ MateriaIDWelling 20 Width PERMIT NO. 7901,?zi. ¢tl No. of compartments 2 Inside length Liquid depth Dwelling PERMIT NO. Liquid capacity in gallons Material Foundation 28 Nearest lot line Trench PERMIT NO. Same Total length of lines 50 inches Distance between lines N/A Material beneath tile 8)~ inches Total ef~e~_~v~ absorption area Depth PERMIT NO. Crib depth Total effective absorption area i Building foundation Nearest lot line Driller Distance to lot line PERMIT NO, Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS Cast To Tank ?VC Perf, · SOIL TEST RATING 85/ INSTAELER REMARKS P C Perff Installed on },'ashed Rock And APPROVED DATE LEGAL 72-013 (Rev. 3/78) F Eld t.[ F;?I')[~ EF::'T F'OI:;~:EHf:tI",I H C: I"t t::t H 1:3 I",! ii ?':] ::[ !.... :i: N[::,EN E:,FL "I""r;F'E:.: Cd::' :ii!;O:fL f::IE'j:j;r"ff?E::TI:ON :,~.:,IEI'I i'.'~i;' TF?.ENCH THEE I:~:IEr2!lJ i R EE[::, "FHE LJ.'ENGTH [::,:[ I',lEt'.,!!.ii; I ON I E; THE L.E:NGTH ,:'. I 1'.,i F'[EE'F ::, O1:: THE TF?.E!'.,ICH OR L':,I:;?.F! ! I",ll:::' :[ Ei:L.D. THE DEF:'T'H OF 13 YF:E:.:NE:H Cfi;?. PIT I~: THE [::, ]: STFII'qCE E',F:i:THIEE':iq THE: 'Ji!;U!~?F!::iC:[':~: OF' 'FH!E I:::iF:()i..Ih,ll'::, f:li'-,t[) THE t3CFI"TOH OF THE Ei::~.;:CF:I'v'!:::!T :[ ON ,:: IN THEi:Fd~ Z 5 .NO ~.;[7:T H :1: E:,¥H FOI:;i: THE Gi:~:FI',/E:I.~. I::,!!Zt::~TI-"I ]:~5 'THEE i"II!'.,t):HI..IH E:,iL:'PTH Oi: 6iFi:FI',,,'EL BETHEIEF~ THE OUTI:::F:II....L. f::liq[::, THE E,:3TTOH OF' THE E"?0::::F:IVFF!"IC~N ,:: IN !::'EET::,. H i N ]: I'"lt..li'"i C, I :!~;"Ft::Ii'.,IC:EE BE:'r'I.,.IEEI'.,I t:::l HE:L..L Fii'.,ID FIN'-r' Oi",l'"':::i; t 'T'E '.E;E:I.,.IF:!GE~: C, I :SF:'OE;F:iL.. t~i;'.,.'"2'TE:M ! :!'3 ::t.~;'3~3 F:EETI" FOR FI F'I:;?.I',,,'F:ITF.' t.,.tELJ.....~ ::l..L:.illi!l "1"O :;?t-3(~i FIFE:'1" F:'F:::OH FI F'I...IE',L.!C: HE:L.L E:,[~.:F'END:r.h!G LII::'Cd'..! THE: T'T'PE: Eft::' F:'IJE!:L. '[ C: HI!EL.t. HELL. L.C','G:5 !::iI:~:E D.i'Eg!LIIFi:E:D F:INE:, I',IL~:;:3'F IE:E:: I:~:E:TUFifl'-,!ED "['O THE E:,FLF:'FIF:THE~I'.,FF t.,.I!'T'HIN -O1:: THIE HEEL. L. COHF'L.r:i:T ]: O!'-,I. OTHE:JI:?. ,fii:E~.~!lJ :[ N:E:HETNTE:.; P'ff::l"r' I::IF'[::'L'T'. :E;I:::'EC: t F' ! C:F!T 1131'.,?."5 I::I[",IE:, (:)i])N~:~;"I'!?.LI('::T F:l'v'l:~ i L.I:::IDL~?: "I"C) I i'.,!,SI..I[:~:E F~ROF'EF: :i: NS;Tf::!L.L.FIT :[ CI1"4. I C:[:EF('I' I [:"T' ]'I"IFI"[' :L: i FtH F'FII'"tlL.:[F:IF?. H ITH "FHE RECE!LIIREH[ENT:~ !::'OF~: F:OD. TH [~:"r' TIdE i'"tLIt'-,l ]: L-: ! F'FIL I T"r' 01:' ;.:::: :[ H I L.L I h!~;TFtL. L THE :~i;'~":E;TE!M ::!i:: :[ I...I[".tD[~:F~::E;TFIt",ID THFIT THE: ON'~"::.~;:[TE: :~[[EI.,.f['E:I:;~'. :~?',"E;TF£M ["!FI"," I:~:E[J:!L.I:[F]:[E ENI..I:::I[;~t(:iiEMEF,FF :[1:::' THE: F~'.E::ii: ]: E:,[Ef'~r':i~L ~ :!5 F.:EHOI?~L..[~O TO ]'~.~C:L.U[)[.::: t'IOF.:E: THFIN 4 E E'[':,F?Cff]fl'"!:5. I:::ff:'F'L. :1: CFINTF?.O[~E:i';?.T f::OFi:EPlf::IN i :-~;:!j;I...l!~i:[) I':',"r' [::,i::l'!"[i~ //r '''~ " /'%' [] SOILS LOG PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6.650, Anchorage, Alaska 99502 276-~221 SOILS LOG- PERCOLATION TEST Bob Foreman DATE PERFORMED: I~,ot 6, Blk. 2, Mc~,~ahon Sub. [] PERCOLATION TEST 5-ii-79 Overbuz~t en v,~ith organics USCS GM-CH Silty snady gravel ~fith some cobbles USCS G~ SLOPE SITE PLAN ~'[ell graded sandy gravel USCS G?f WAS GROUND WATER N0 ENCOUNTERED? IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT Lot is covered with large trees and has good natural drainage. Soils rated at 8~ s.f. / Bedroom PERFORMED BY: '~*~' 72-008 (7/76} CERTIFIED BY:/.~~Y~'~'~DATE:. David ~a~an /~ x~-'.\ STATE OF ALASKA RETURN TO:~ Dlvlslon of Geological and ' )yslcai Surveys (DGGS) DEPARTHENT OF NATU~L RESOURCES ~ ~ 300l Porcupine Drive (Tele~ Anchorage, Alaska 9~50l '; , '. WATER WELL R E C 0. R ~ Drilling Company Name 'i";'~i!l:i !~i]-;=i[,! i" L '~', ~', U,S.G.S. Local liD. ~ ':Orllllng Permit No. la. 8orough Subd~vlsion Lot Block lb. Fraction Section N~. Township Range Herldlan Street Address and Area of ~ell Location 2. ~ELL LOG Feet Bel~ ~- ~ELL OEPTH: (completed) Surface Elevation Date of Surface C~pl et i on Haterial Type Top eottom ~ ~ ~, Ft. 6. US[: ~Do~stlc ~Public Supply ~lndustry 8, FINISH OF ~ELL: Slot/Hesh Size: Length: Fittings: 9. STATIC ~ATER LEVEL: ~'"~- ft. ~A~ve ~eelo. land surface 10. PUHPING LEVEL belo~ land surface ft. after hrs. pumping g.p.m. ft. after hrs. pumping g.p.m. 1~. ~ELL H~D C0HPLETION: ~ In Approved Pit 12. GROUTING: ~ell Grouted: ~Yes Haterla1: ~Neat Ce~nt Length of Drop Pipe f~. ca~cl~y g.p.r Type: ~ Sub~rslble ~Reci~rocating ~ Je~ ~ Other: 1~. REHARKS: 15. WATER WELL CONTRACTOR'S CERTIFICATION: This well was drilled under my jurisdiction and this report is true to the best of my knowledge and belief: Registered Business Name Address: } i ~[:: ~ '!"1 ~! ,~[?:~ ~ · I~ ~.!; ' :; :~ ~ Signed: . ;' ':~:?','[':~ ~,:'r' ~ !' ~' ' ,. '; Authorized Representative CoDy Oistribution: Contract License Number WHITE - State DGGS~ PINK - Driller, CANARY - Customer WATER WELL LOG FOSS DRILLING 1336 Ingra Street WELL OWNER Rnb~rt H. Mnr~man LOCATION T.nt g: Block 2. McMahon Subdivision ~[~UNICIPALITY OF ANCH?RAQE DEPT. C,;: ~! },'~:LTF[ ~ ~:~'~.VIRONMENTAL P~OTECTION JUL i i 1979 Anchorage, Alaska 99501 SIZE OF CASING 6" DEPTH OF HOLE 11.2~T. CASED TO 112 STATIC WATER LEVEL ~4 FT. YIELD__~4LGA~.PER.MIN. WITH FEET OF DRAWDOWN. 2O REMARKS DATE COMPLETED 6/7/79' PUMP TO BE SET AT 0 to 13 ALVM Brn. 13 to 26 ALVM Grey 26 to 33 AT~M Grey 3.3. to. 40 ALVM Grey 40 to 87 A~V~ .. Grey 87to 94 . ALVM . Brn, 94 tolOl ATOM Meal. Har8 Hard Ha r~ /_Q~_toll2-,- ._~vel With Water .__to to__ to tO__ ItO to __to to MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 017-041-28 \' ' GENERAL INFORMATION Complete'legal description Lot 6; Block 2; McMah°n Subdivision Location (site address or directions) Property owner Mailing address 3830 McMahon Ave. Anchoraqe, AK Jeff & Paige Spatz. Dayphone 011441224740119 Mill Lade House, Easter Ord Westhill, Aberdeen AB32 6SQ U.K. Lending agency Mailin. g address Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. 4 NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank' Community on-site Public sewer NOTE: xx If community wastewater system, prOvide written confirmation from State ADEC attesting to the legality and status of System. 72-025 (Rev, 1/91) Front MOA #21 o STATEMI~NT OF INSISECTION BY ENGINEER As certified, by my seal affixed hereto and as of the validation date shown beloW, I verify that my i'nvestigation Of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection; the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm AI. ASKAWATER&WAb-'TEWATER Phone. ~ Address I~]01 DEBARR ROAD, SUITE 2B ANCHORAGE, ALASKA 99504 Engineer's signature Date Alaska Water & Wastewater Consulta~nts, In¢, Shall be PAID $ N/~ ~ or prior to, closing for the Engineering Servic_es Provided. DHHS SIGNATURE ~ Approved for ~)UI~-~ Disapproved. Conditional approval for bedrooms. bedrooms, with th-e following stipulations: Additional Comments 'The Municipality of Anchorage Department of'Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025(Rev. 1/91) Back MOAt¢21 RECEIVED Municipality of Anchorage APR 1 9 DEPARTMENT OF HEALTH & HUMAN SERVICE~N~OP^u~, oF ^NCH~ Environmental Services Division ~N¥1RQNMt~NTALSERvIcE~ I~/ 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist LegalDescription: I~A~4o~4 -~y/'0; Lo-r /~ ~,~-I~, 'Z1 ParcelI.D.: A. WELL DATA Well type Log present ~N) Total depth i I Sanitary seal (~/1~ If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to J I Z ! Casing height (above ground) Wires properly protected (~/N) Date of test Static water level Well production FROM WELL LOG AT INSPECTION ~ g.p.m. ~,.q g.p.m. WATER SAMPLE RESULTS: Coliform Date of sample: ~//o/~,~ B. SEPTIC/I~JCl~TANK DATA Date installed Foundation cleanout {~/N) Nitrate Collected by: Other bacteria A.cJ.c~ .c-.~ ~Jc. Tank size I ~GO Number of Compartments '1/~,~ Depression (Y~ /",Jo High water alarm (Y/(~)_ /k Jo Date of Pumping t,J~ Pumper -- L C. ABSORPTION FIELD DATA Date installed Length .~'[~Z~) Width ~_1 Effective absorption area '7¢~¢ Date of adequacy test 'J~ ¢ ~ Soil rating ~or fF/bdrm) 0.~ System type ID~-¢ 'T'~a,¢~. Gravel thickness below pipe -7 Total depth I o -- J 1.5'~ Monitoring Tube present {~1~ Ye..~ Depression over field (Y/~ /U o Results (J~-ail) For /'~ bedrooms Fluid depth in absorption field before test (in.); - '~ Immediately after .---- gal. water added (in.): ' ' Fluid depth. ~" (ins) Minutes later: -'--- Absorption rate = ~ .g.p.d. Peroxide treatment (past 12 months) (Y/N) ~ If yes, give date 72-026 (Rev. 3/96)* LIFT STATION' Manhole/Access (Y/N) ~__ "Pump off" level at* High water alarm~ *Datum ~~ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/l~ tank on lot I ool'ff Absorption field on lot J '~ I ~ On adjacent lots On adjacent lots Public sewer main Sewer/septic serv!ce line '7,,5 I,~. Lift station SEPARATION DISTANCES FROM SEPTIC/,~{J~ TANK ON LOTTO: Foundation 'Z'-~' I-~ Property line Go I.[.. Absorption field Water main/service line J el-f- Public sewer manhole/cleanout Surface water/drainage JooJ-~ Wells on adjacent lots F. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ~°l~ Building foundation L]'~I't' Water main/service line Surface water I coI'~" Driveway, parking/vehicle storage area Curtain drain k~o~ ~,~,,~ ~/ Wells on adjacent lots J Ool'f' ENGINEER'S CERTIFICATIO~/' I certify that l/l'~ ,de~i~d~t~ru hild inspections and review of Municipal in conform~ce 4~/HA~g~ in effect on this date. Signature ~ Engineer s Nam~ _ Date '4/~/C~ joel/- HAA Fee $ "~ ~7~'~ ' ~-B Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev, 3/96)* MAR=lO-gg IT:4g FROM-¢TE r(qVIRON~/,ENTAL · ~lRtl~ CT&~ Envimnrnenml $~rvi~es Inc. T-48~ P.OZ/O$ P-808 CT&E ReL# 990916001 Client Nme AK Wa~r ~oj~ N~/~ 9830 Ordered By ~S~ 0 Sample Rcm~ks: o,loo RECEIVED APR 9 1999 Municipality of Anchorege Dept. Health & Human Services MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING _/~t. ,.~'/~ ,,?.~, NAA # 1. GENERAL INFORMATION Complete legal description Lot G 5'.oc~ ~ Pt ~- iVlc~hrm Xc~b. Location (site address or directions) 38&o FM-Pb. ho~ A~¢.. Anchoraae I d ~ Property owner Mailing address Lending agency Mailing address Agent ~//~ Address j Day phone ,345 -3570(k~ HO¥~EadLc1~. Day phone D('o?_-- ~GZ~ ~ J Ave .quffe I0o Anc. horaoe ~ 5~5o3 ~lS Day phone G.~o~ 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. 4 ~' NOTE: X Individual well Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: X Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA ~21 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and typo of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ~.~L~ Address .P.O. AOX Engineer's signature Phone Date DHHS SIGNATURE ~;¢('~ Approved for /~-'~--~- f/~z~)~_ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA ~21 ) Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST A. WELL DATA Well type Log present (Y/N) LC Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number ¢,J/~ Date completed ~-'7--~(D Driller I:'tO$5 D~IL. LI~I~Y Cased to I t?-f+(:p Casing height Z, I '~'~ Wires properly protected (Y/N) I¢ _.~ g.p.m. FROM WELL LOG Date of test (~'7-79 Static water level Well flow Pump level ~JOT SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot IDI ",~) {-~- Absorption field on lot Public sewer main Sewer service line ~) ~ LfEST)H~-¢~b) AT INSPECTION 71 R- ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate 3.4 ,,~/.~ ~ j, Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed ~-~-0- 7'~(~ Tank size {~O (~) Compartments Cleanouts (Y/N) LC (.Ofld.') Foundation cleanout (Y/N) t~ ~ Depression (Y/N) High water alarm (Y/N) M/~ Alarm tested (Y/N) ~ M Date of pumping iL-23-gZ. Pumper SEPARATION DISTANCES FROIVl~,~EPTIC/HOLDING TANK TO: WeH(s)on~otl .~5 ' o adjacentlots I~-~Jr(~)~ Foundation To property line ,~ '~'{'(~ ~ Absorption field I ,,5'~]- -~ ~/service line Surface water/drainage ~O3'~E F't3L[k~O (~ 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION ~/~. D'ate. i~..,~t al I ed Manufacturer Size in !~_ Manhole/Access (Y/N) Vent (Y/N) ~%vel at __ "Pump off" level at High water alarm level ~'"~ Cycles tested _____ Meets MOA electrical codes (Y/N) ____. SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date in,stalled Length 3~'~ Width Total absorption area Depression over field (Y/N) Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) _ Soil rating {~O(~) System type TC.E/OCt-t Gravel thickness f ~)'t;J¢(~) Total depth Cleanouts present (Y/N) (¢ Date of adequacy test l-I~-.~ for ~ ~,,JO'/~E. If yes, give date /~/'% bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot il2_¢~- To building foundation On adjacent lots c~ ;~ On adjacent lots 174 ¢t'~¢-D' Property line ~dr ~r~- To existing or abandoned system on lot Cutbank ~OM~ ~/service line ~O'~'~ Surface water Curtain drain E. ENGINEER'S CERTIFICATION Driveway, parking/vehicle storage area I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect Engineer's Name ~FEY~'~ C ~'~E Date ~'-/~- f this inspection. Waiver Fee: $ Date of Payment Receipt Number bo~ G CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 Chemlab Ref.S :93.0128-1 Client Sample ID :POTABLE WATER WELL L6 32 MCMANON Matrix : WATER REPORT of ANALYSIS Client Name :S K L N CONSULTANTS Ordered By :S. NENSLEE Project Name : Projects : PWSID :UA Collected :01/11/93 @ 15:06 Received :01/11/93 @ 15:30 hrs. WORK Order %2231 Report Completed :01/13/93 Technical Director ~TEPNEN C. EDE Released By : Sample Remarks: ROUTINE SABLE COLLECTED BY: S.H. QC Allowable Extract Analysis Parameter Results Qual. Units Method Limits Date Date NITRATE-N 3.24 mE/1 EPA 353.2/300.0 10 01/13/93 01/13/93 See Special Instructions Above UA = Unavailable See Sample Remarks Above NA = Not Analyzed Undetected, Reported value is the practical quantification li~t. LT ~ Less Than Secondary dilution. GT = Greater Than ~ S[~-~ Member of the SGS Group (So¢{Oi~ GdnOra{e do Survei,,ance) MUNICIPALITY OF ANCHORAGE ~) l' DEPARTMENT OF HEALTH & HUMAN SERVICES ..... D V,S,O. oF E.WRO.ME.TAL SERWCES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORI~ APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Locatibn (address'6r, directions) Business RealEsti~eO0mP~y~nS~gent ~~2 - ~¢ , Mail the HAA to the followina address: or: Check here ~ if hold for pick up. List contact person and day phone number below. (b) (c) (d) (e) 2. TYPE OF RESIDENCE Single-Family~ Number of Bedrooms ¥ WATER SUPPLY ..' i : Individual Well~[~, Community [] Public [] '. · ' Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. : : -~ 4. SEWAGE DISPOSAL ' Onsite~ Public [] Community [] Holding Tank [] ' Note: If community well system, must have Written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 fRev 8/86} Front ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ~'~ Telephone ~<"G,/--,<~ ¢o Address /'~'~ /'J ~?~' p'~/2'''-~'' .z~ ,/~,/,~ /~ ~'~.5'~..~ Date / ~- --'~ ' ~' 7 .Approved for ,~'-¢,-~//"/'//) bedrooms by . . Approved ~ Disapproved Conditional Terms of Conditional Approval CAUTION The Municipality of Anchorage Department of Health and 'Human Services (DHHS) issues Health Authority Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska, The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work, Page 2 of 2 72-025 fRev 8/861 Back ;~ONM~,.. -- ANn,. MUNICIPALITY OF ANCHORAGE ( O ) c~I1Ai. SER~,,~'~OP, ACEHEALTH AUTHORITY APPROVAL (HAA) "~'"'$ °/VIS/oN CHECKLIST - FEBRUARY 1984 $19.97 264-4i'44 Legal Description: ~' ~--'~' ~ R£C£11/£D WELL DATA Well Classification ~;~,~E/v~/~-7-'~' If A, B, C, D.E.C. Approved (Y/N) Well Log Present~/N) Date Completed ~ -~' Yield Total Depth //~' Cased to //~ / Depth of Grouting Static Water Level -~ ,,~'-¢-/' Pump Set At ,a//,,,~ Casing Height Above Ground Electrical Wiring in Conduit~'N) Separation Distances from Well: To Septic/Holding Tank on Lot Sanitary Seal on Casingi~N) Depression Around Wellhead ! ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot /~'O/'f" ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by /~'~¢'5 /~' ~J/~"'v/ ; Date Water Sample Test Results ~'~-~ ~ ~"~ Comments "~ /~/~¢'/-/-~ ~rz~'O '7-~'~' //~?'~ · B. SEPTIC/HOLDING TANK DATA Date Installed '~'-~.z:) ~ Size /~-'~'~ No. of Compartments Standpipes ~)N) Air-tight Caps(~N) Foundation Cleanou~,l) Depression over Tank (Y~) Date Last Pumped Pumping/Maintenance Contract on File (Y/N) ,~j/~4 ; for ~J/~'~. Holding Tank High-Water Alarm (Y/N) ~/~r- Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To property Line · .. TO Water Main/Servic~ Li~e. /o ' Course ,' ..i,~ /~'O "/'- To Building Foundation To Disposal Field //¢' ..r To Stream, Pond, Lake, or Major Drainage Con~ments Page I of 2 72-026 fRev 8/86~ Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field -'~ Square Feet of Absorption Area '? Depression over Field (Yt~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot /~ To Water Main/Service Line Type of System Design Length of Field Depth of Field /¢ · Gravel Bed Thickness /O Standpipes PresentON) Date of Last Adequacy Test To Property Line :~ To Existing or Abandoned System on ; On Adjoining Lots /~ /C- To Cutbank (if present) ,~J,/~ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D, LIFT STATION Size in G al Io~¢Ts'-~- "Pump On" Level High Water Alarm Level at "'"~"'"'"~-,-.-~ Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) ' ~'"'----P_,,~mping~ Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have ¢.~ecked, verified, or confermed to all MOA and HAA guidelines in effect on the date of this inspection. Signed '"¢¢¢¢~'" -~' ~')~'~ I-)ate Company "~¢~¢"¢ MOA No. Receipt No. /0 0 / O O O ~ Date of Payment /2//,,TJ~ Amount: $ Page 2 of 2 72-026 fRev 8/861 Back FEDERAL TAX ID # 92-0040440 To: AECS ~t,uH0~$~, Al. W503 Work Order No. : 40?4 ¢lien[ Account : a,.¢oR~ Date Report ?rinteO: ~107 30 ~7 ~ zO:~6 Reporb3 hddreea ~2 ~.I;St t'L,C t: Chemlab Ref ii: 8438 Lab %pi ID: ~latrix: Water Parameter ?ested Result/Units Method Limits Ely'~UNICIPALITY 0 . ,'~vh~ONMElm.,' ~ F ANCHo~,,~r... 3 1987 RECEIVED ................... - ...... ==.-= ................... -=.==2.;~:.. ..................... Detected ~ S~.~o S~pJe Re~Tt;~rks Above MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date [ _~) GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address*o~ 8imctions) (b) 'Applicant Name' ~L,~,~ '~1RN Telephone: Home (c) Applicant., :, ~' ~s~(C~Ck:~:O~e~'~n~ing. . ~ ~.' t¢~.~ ~.~ Institution D; Ownor/builder~'; Buyor D; Other D (explain):~ (d) Len~ihg Institution~2 ,~/ Telephone Address (e) Real Estate Company and Agent Address t ~// FJ Telephone (f) Mail the HAA to the following addr~ Business TYPE OF RESIDENCE Single-Familyj~ Multi-Family D Number of Bedrooms ~ Other 3. WATER SUPPLY · Individual Well,~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL .OnsiteJ~ Public [] Community [] Holding Tan'k~[] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) ,ENGINEERING FIRM PROVIDIh~ INSPECTIONS, TESTS, FILE SEARCH, D~ f'A AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ~E~---.~ ll~, Address Date Telephone pproved for ¢_~¢~_~ bedrooms ate Approved //J Disapproved Conditional Terms of Conditional Approval ' CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representatiops given in paragraph 5 above by an independent professional engineer registered in the State of Alaska, The DHEP does this as a courtesy to purchasers of homes and thei? lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued· The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work· Page 2 of 2 72-025 ( 11/84) WELL DATA MUNICIPALITY OF ANCHORAGE (MO~i HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Legal Description: Depth of Grouting Pump Set At Sanitary Seal on Casing ON) Depression Around Wellhead (Y~ Well Classification j~'Ol U'/~d,z~/--, If A, B, C, D.E.C. Approved (Y/N) Well Log Present (~)N) Date Completed /¢/7 /7? Yield Total Depth ! t/Z- / ~ Cased to 112-- ~' Static Water Level ~'-~¢ ~ · Casing Height Above Ground ~" ~" Electrical Wiring in Conduit (~)/N) Separation Distances from Well: TO Septic/Holding Tank on Lot 1~)0 ! ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot I I,~'/'h ; On Adjoining Lots To Nearest Public Sewer Line ~///~' To Nearest Public Sewer Cleanout/Manhole ~ / ~ To Nearest Sewer Service Line on Lot Water Sample Collected by ~'~"J~ J,~Ii~'(_~X~ ;Date Water Sample Test Results ~.~TL.% ~1~1'0~/ lO0 Comments B. SEPTIC/HOLDING TANK DATA· Date Installed ?/~.0/~? Standpipes ~N} Depression over Tank (Y(~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line To Water Main/Service Line Course ~ OO / ~ Size ) ~-5-0 No. of compartments ~, Air-fight Caps ~)N) Foundation Cleanout (~N) Date Last Pumped ,~//~'~/~ /~//¢¢ ;for /V//~' Temporary Holding Tank Permit (Y/N) ! I oo 20 To Building Foundation ~-(~ / To Disposal Field ~0 ¢ To Stream, Pond, Lake, or Major Drainage · Comments · Pagelof2 . ~ 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata I ~'O Date Installed ~/~-~ I / ~...~ Width of Field ,,'3 / Square Feet of Absorption Area Depression over Field (Y(~) Results of Last Adequacy Test %0 Type of System Design Length of Field ~ / Depth of Field /L/ r Gravel Bed Thickness /O Standpipes Present ~)N) Date of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation ~.~ Lot .~.~O To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Property Line To Existing or Abandoned System on ; On Adjoining Lots ~"(~" To Cutbank (if present) /V/,/~ ] OO Comments D. LIFT STATION Date installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at / "Pump O~___ High Water Alarm Level at ~ ///~ .,-,.~ent (Y/N) _ Tested for I"~' /1~/''/ Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I hav~ c.h~.~ked, ver(~ied, o.r conformed to all MOA and HAA guidelinesin effect on the date of this inspection. Signed Q A~/~ ~("//~~ .Date Company d'fl ~'~ C-~ t'/~/'(~, MOA No. ReceiptNo. ~.O~ ~ Date of Payment Amount: $ ~'~ Page2 of 2 72-026 (11/84) ALASKA b,dlROFlmeF1TAL COF1TROL I~n§ineerinq 8 ~nuironmenlol Studies InC. AUGUST 13 1986 ALAN ADRIAN 3830 MCMAHON ANCHORAGE ALASKA 99516 SELLER-SAME 60438 LEGAL:MCMAHON BLOCK 2 LOT 6 ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE-AUGUST 11 1986 ALAN ADRIAN 3830 MCMAHON ANCHORAGE ALASKA 99516 MUNICIPAUTY OF ANCHORAGE DEPT, OF HEALTH & ENVIRONMENTAL PROTECTION -AU6 i 41986 RECEIV£D THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 760 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 1241 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 4 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR THIS 4 BEDROOM HOUSE. THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON MAY 24 1986 . THIS REPORT DOES NOT VERIFY THE INTEGRITY OF THE PIPING FOR THE WATER SUPPLY OR WASTEWATER SYSTEM. FLOW TEST ON WELL WELL FLOW DATE-AUGUST 11 1986 A FLOW TEST WAS PERFORMED ON THE WELL. 1241 PUMPED AT A RATE OF 5.64 GPM OVER A DURATION OF THE DRAWDOWN WAS 11 ' WITH A RECOVERY TIME OF 10 AND THE STATIC WATER LEVEL WAS 85.2 FEET. THE WELL IS ADEQUATE FOR THIS 4 BEDROOM HOME. GALLONS OF WATER WAS 3.65 HOURS. MINUTES ADDI TIONA~.CDMMENTS : A ALASKA ENVIRONMENTAL CONTROL SERVICe, INC. 1200 West 33rd Aven~, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 SHEET NO. OF CALCULATED BY CHECKED BY DATE 30' DATE ........... !!~iiiiiii! .......... ..... ......... ..... ......... ...... ......... .......... ........... i"ii'~'~-i '~" · ,C.~ ~,; ,'-. DATE RECEIVED I NSPECTI ON APPOI NTM ENTS ,,~.) TIME TIME TIME DATE DATE DATE MUNICIPALITY OF ANCHORAGE E~IRONMENTAL PROTE~ION 825 L Street- Anchorage, Alaska 99501 [10V ] 1979 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 REQUES~ FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. P~PERTY OWNER PHONE M~l~lfld' AffD~ESS PROPERTY RESID (If aifferent f~o~ above) '" PHONE 2. BUYER PHONE MAILING ADDRESS 3. LENDING,INSTITUTION I PHONE 4. ~ALTOR/AGEflT ~ ' ' PHONE M~b ADDRESS ' 5. LEGAL DESCRIPTION STR-E 8T LO~TION ..... 6, TYPE OF RESIDENCE [~SING LE FAMILY MULTIPLE FAMILY NUMBER OF~BEDROOMS [] One ~- Four [] Other__ [] Two [] Five [] Three [] Six 7. WATER SUPPL/Y [~'1N DIVI DUA L* [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ~ I NDIVI DUAL/ON-SITE** [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [~ ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [~ TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] iNDIVI DUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [~] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED [] PUBLIC UTI LITY Connection Verified INSTALLER [~]Septic Tank or []Holding Tank Size: I ~L~ If Tank is homemade SOIt. S RATING give dimensions: TYPE OF TANK MANUFACTURER ~..~.. _ . TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line I WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS [~"APPROVED FOR ~" __ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED ,~~ DATE BY 72-010 (Rev, 6/79)